Bolukbas Filiz F, Bolukbas Cengiz, Y Balaban Hatice, Aygun Cem, Ignak Seyda, Ergul Emine, Yazicioglu Mehtap, S Ersahin Suat
Department of Gastroenterology, Bahcesehir University School of Medicine, Medicalpark Goztepe Hospital, Istanbul, Turkey.
Department of Gastroenterology, Istanbul Medipol University School of Medicine, Istanbul, Turkey.
Euroasian J Hepatogastroenterol. 2017 Jul-Dec;7(2):126-129. doi: 10.5005/jp-journals-10018-1232. Epub 2017 Sep 29.
Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease in pregnancy. Although it was shown that multiple pregnancy and hormone therapies increase the risk of ICP, there is limited information that compared spontaneous fertilization and fertilization (IVF) from the aspect of developing ICP. In our study, we investigated the potential relationship between ICP and IVF/ spontaneous pregnancy.
We reviewed the records (between June 2007 and December 2014) of pregnancies with ICP who were referred to gastroenterology clinics in three different hospitals. Fifty-nine pregnancies (43 spontaneous fertilization, 16 IVF) with ICP were analyzed from the aspect of age, fertilization type, multiple/singleton pregnancy, delivery week, and biochemical results.
We found that serum bile acid levels were higher in the IVF group than the spontaneous fertilization group (32.8 ± 20 19.6 ± 19 μmol/L; p < 0.05). There was a significant inverse correlation between serum bile acid levels and gestational age (r = -0.42, p < 0.01) in the whole group. There was no difference between IVF and spontaneous fertilization groups in term of age, onset time of symptoms, serum alanine aminotransferase (ALT), alkaline phosphatase (ALP), total and direct bilirubin levels, prothrombin time (PT), international normalized ratio (INR), and platelet count.
Our results suggest that the serum bile acid levels are higher in IVF than in spontaneous pregnancies with ICP, but its clinical implications are not clear. Further prospective studies with large number of ICP cases are needed to clarify the effect of IVF on ICP. Bolukbas FF, Bolukbas C, Balaban HY, Aygun C, Ignak S, Ergul E, Yazicioglu M, Ersahin SS. Intrahepatic Cholestasis of Pregnancy: Spontaneous Fertilization. Euroasian J Hepato-Gastroenterol 2017;7(2):126-129.
妊娠期肝内胆汁淤积症(ICP)是妊娠期最常见的肝脏疾病。尽管已表明多胎妊娠和激素疗法会增加ICP的风险,但从发生ICP的角度比较自然受精和体外受精(IVF)的信息有限。在我们的研究中,我们调查了ICP与IVF/自然妊娠之间的潜在关系。
我们回顾了2007年6月至2014年12月期间转诊至三家不同医院胃肠病科的ICP妊娠记录。从年龄、受精类型、多胎/单胎妊娠、分娩孕周和生化结果等方面分析了59例ICP妊娠(43例自然受精,16例IVF)。
我们发现IVF组的血清胆汁酸水平高于自然受精组(32.8±20对19.6±19μmol/L;p<0.05)。全组血清胆汁酸水平与孕周之间存在显著负相关(r=-0.42,p<0.01)。IVF组和自然受精组在年龄、症状出现时间、血清丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、总胆红素和直接胆红素水平、凝血酶原时间(PT)、国际标准化比值(INR)和血小板计数方面无差异。
我们的结果表明,ICP患者中IVF的血清胆汁酸水平高于自然妊娠,但临床意义尚不清楚。需要进一步进行大量ICP病例的前瞻性研究,以阐明IVF对ICP的影响。博卢克巴斯FF,博卢克巴斯C,巴拉班HY,艾贡C,伊格纳克S,埃尔古尔E,亚齐乔格鲁M,埃尔萨欣SS。妊娠期肝内胆汁淤积症:自然受精。《欧亚肝脏胃肠病学杂志》2017;7(2):126 - 129。